Provider Demographics
NPI:1255448346
Name:COLLINS, PATRICIA WALTON (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:WALTON
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5213 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612
Mailing Address - Country:US
Mailing Address - Phone:919-781-0334
Mailing Address - Fax:
Practice Address - Street 1:2310 STINSON DR
Practice Address - Street 2:NCSU DEPARTMENT OF PSYCHOLOGY POE HALL RM 640
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27695-7650
Practice Address - Country:US
Practice Address - Phone:919-515-1713
Practice Address - Fax:919-515-1716
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1718103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool